Eso-SPONGE® – Endoluminal vacuum treatment in staple line failure and perforations of the upper GI tract

A 55-year-old male patient with squamous cell carcinoma of the distal third of the esophagus had undergone abdominothoracic esophagectomy with gastric conduit reconstruction and end-to-end esophagogastrostomy (manual suture) following neoadjuvant chemoradiotherapy. On postoperative day 5, elevation of the infection markers was noted. Endoscopic follow-up examination revealed staple line failure affecting approximately one-quarter of the anastomotic circumference 25 cm from the dental arch. The leakage cavity behind it was visualized to a depth of about 8 cm. During the same examination, the first Eso-Sponge was inserted into the leakage cavity. The following video demonstrates the second Eso-SPONGE® replacement.

The Eso-SPONGE® treatment set comprises an open-cell polyurethane sponge inserted through an overtube with pusher, rerouted transnasally and then connected to an adjustable medical pump. To prepare for treatment, unpack the components of the set; if necessary, already thread the drainage tube of the sponge through the pusher. Prepare sterile hydrogel, NaCl or Ringer solution, a Ch. 16 gastric tube, and various clamps.